title: Proliferative activity in Libyan breast cancer with comparison to European and Central African patients.
abstract: BACKGROUND
  We evaluated the relation of proliferative indices with clinicopathological features and prognosis in breast cancer (BC) of Libyan female patients. The data were compared with corresponding results in Finland and Nigeria.
  
  
  METHODS
  Histological samples of breast cancer from 130 patients were retrospectively studied. Mitotic activity index (MAI) and standardized mitotic index (SMI) were estimated.
  
  
  RESULTS
  There were statistically significant correlations between the proliferative indices and most clinicopathological features, with the strongest association observed for histological grade (P = 0.01 for SMI and P = 0.003 for MAI). The proliferative differences between Libyan, Nigerian, and Finnish population were prominent. The mean values of SMI and MAI in Libyan BC patients were 32.1 mitotic figures per square millimeter and 27.3 mitotic figures per 10 high-power fields, respectively. This is clearly lower than those in Nigeria but much higher than those in Finland. The differences between countries are seen in whole material and are also present in subgroups. The results indicated that mitotic activities can be reliable prognostic indicators in Libyan BCs, as they were among Finnish and Nigerian females. Univariate and multivariate analyses found at cut-offs of 19 and 44 mitosis/mm(2) of SMI were the most significant prognostic factors.
  
  
  CONCLUSIONS
  Proliferative indices with careful estimation of the MAI and SMI could be applied as quantitative criteria for Libyan BC to separate the patients into good, moderate, and bad prognosis groups.
authors.affiliation: Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland ; Department of Pathology, National Cancer Institute, Misurata, Libya.
authors.forename: Jamela
authors.initials: J
authors.lastname: Boder
authors.forename: Fathi
authors.initials: F
authors.lastname: Abdalla
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elfagieh
authors.forename: Abdelbaset
authors.initials: A
authors.lastname: Buhmeida
authors.forename: Yrjö
authors.initials: Y
authors.lastname: Collan
mesh_terms: D000328:Adult; D044383:Black People; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology*; D049109:Cell Proliferation; D005260:Female; D005387:Finland; D006801:Humans; D008002:Libya; D008875:Middle Aged; D008938:Mitosis; D008940:Mitotic Index; D009549:Nigeria / Q000453:epidemiology; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D044465:White People